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Symptom Checker

Step 4: Read and complete the decision guide to learn more about your symptoms.

Causes of Impotence

Okay. So far, you've indicated that you are age 45 or older and that you

  • don't take medications

  • don't use alcohol or drugs

  • don't have diabetes

  • haven't had pelvic surgery

  • haven't had spinal cord or nerve injury

  • don't have symptoms of a hormonal problem

  • aren't suffering from stress or relationship issues

  • never (or almost never) get normal erections.

In most men who fit this description, impotence is usually caused by poor blood flow to the penis (vascular disease). Studies suggest that poor blood flow is the main cause of impotence in up to 70 percent of men. Blood flow problems are particularly common in men who have had heart disease, vascular problems affecting the legs, high blood pressure, and/or high cholesterol. Blood flow problems are also more common in men who smoke.

Impotence caused by poor blood flow may or may not improve with time. However, drugs used to treat impotence may be particularly effective in men who have this type of problem. Please visit our Decision Guide on Treatment of Impotence.

Regardless of whether you would like treatment, men who may have poor blood flow as a cause of their impotence should contact their doctor. That's because impotence can be a sign of poor blood flow to other important organs, including the heart. Your doctor may recommend a medical evaluation, including measurement of your blood pressure and cholesterol, and tests to ensure that your heart is working normally.


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